Accessibility of Mainstream Services for Aboriginal Victorians

 
Accessibility of Mainstream Services for Aboriginal Victorians
Accessibility of Mainstream Services for Aboriginal Victorians
                                                                                                                                                       Accessibility of Mainstream Services
                                                                                                                                                                     for Aboriginal Victorians

                                                 May 2014

                                                                                                                  Victorian Auditor-General’s Report                                May 2014     2013–14:28
                                                 2013–14:28

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Accessibility of Mainstream Services for Aboriginal Victorians
Accessibility of Mainstream Services for Aboriginal Victorians
VICTORIA

                                 Victorian
                              Auditor-General

     Accessibility of
  Mainstream Services
for Aboriginal Victorians

                              Ordered to be printed

                                  VICTORIAN
                             GOVERNMENT PRINTER
                                   May 2014

PP No 325, Session 2010–14
Accessibility of Mainstream Services for Aboriginal Victorians
Photo attributions
  Photographs by Tobias Titz. Thanks to the organisations for making their
  premises or events available for the photographs.

  Except where otherwise indicated, the images in this publication show models and
  illustrative settings only, and do not necessarily depict actual services, facilities or
  recipients of services.

This report is printed on Monza Recycled paper. Monza Recycled is certified Carbon Neutral by The Carbon
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ISBN 978 1 922044 83 9
Accessibility of Mainstream Services for Aboriginal Victorians
The Hon. Bruce Atkinson MLC                                    The Hon Christine Fyffe MP
                  President                                                      Speaker
                  Legislative Council                                            Legislative Assembly
                  Parliament House                                               Parliament House
                  Melbourne                                                      Melbourne

                  Dear Presiding Officers

                  Under the provisions of section 16AB of the Audit Act 1994, I transmit my report on the
                  audit Accessibility of Mainstream Services for Aboriginal Victorians.

                  The audit examined the access to mainstream services for Aboriginal Victorians that
                  are provided or funded by government departments, and it assessed whether
                  departments can demonstrate how improved access has contributed, and is expected
                  to contribute to improved outcomes.

                  I found that despite departments developing programs aimed at increasing access,
                  outcomes have not improved significantly and in some cases the gap has worsened. A
                  lack of broad consultation and problems with data reliability mean that departments
                  cannot be assured they understand the needs of Aboriginal Victorians.

                  With the exception of the Department of Health, departments do not know if the work
                  they are undertaking is improving access, and why outcomes are not improving. As a
                  result, departments cannot be assured they are on track to meet the targets in the
                  Victorian Aboriginal Affairs Framework. There is a lack of effective oversight and
                  coordination by the Secretaries’ Leadership Group and the Office of Aboriginal Affairs
                  Victoria. Without improvements in these areas, it is unlikely the Victorian Aboriginal
                  Affairs Framework 2013–18 will be effectively implemented.

                  I have made eight recommendations, six targeted at the Departments of Health,
                  Human Services, and Education and Early Childhood Development, and two targeted
                  at the Office of Aboriginal Affairs Victoria in the Department of Premier and Cabinet.

                  Yours faithfully

                  John Doyle
                  Auditor-General

                  29 May 2014

Victorian Auditor-General’s Report            Accessibility of Mainstream Services for Aboriginal Victorians   iii
Accessibility of Mainstream Services for Aboriginal Victorians
Accessibility of Mainstream Services for Aboriginal Victorians
Contents
                         Auditor-General's comments .................................................................... vii

                         Audit summary .......................................................................................... ix
                             Conclusions ............................................................................................................. ix
                             Findings ................................................................................................................... xi
                             Recommendations ................................................................................................. xiv
                             Submissions and comments received ................................................................... xiv

                         1. Background .......................................................................................... 1
                             1.1     Introduction ..................................................................................................... 1
                             1.2     Previous VAGO audits ..................................................................................... 8
                             1.3     Audit objective and scope ............................................................................... 9
                             1.4     Audit method and cost .................................................................................. 10
                             1.5     Structure of report ......................................................................................... 10

                         2. Understanding the needs of Aboriginal Victorians................................. 11
                             2.1     Introduction ................................................................................................... 12
                             2.2     Conclusion .................................................................................................... 12
                             2.3     Understanding Aboriginal service needs ....................................................... 13

                         3. Plans, programs and strategies ........................................................... 21
                             3.1     Introduction ................................................................................................... 22
                             3.2     Conclusion .................................................................................................... 22
                             3.3     Adequacy of plans and strategies for service delivery .................................. 23
                             3.4     Collaboration and coordination ..................................................................... 30

                         4. Access, outcomes, monitoring and reporting ....................................... 33
                             4.1     Introduction ................................................................................................... 34
                             4.2     Conclusion .................................................................................................... 34
                             4.3     Access to services ........................................................................................ 34
                             4.4     Measuring outcomes ..................................................................................... 38
                             4.5     Monitoring and reporting ............................................................................... 41

Victorian Auditor-General’s Report                               Accessibility of Mainstream Services for Aboriginal Victorians                           v
Accessibility of Mainstream Services for Aboriginal Victorians
Contents

                          Appendix A. Barriers to access and required actions ................................ 47

                          Appendix B. Mainstream services, strategies and programs ..................... 49

                          Appendix C. Progress toward targets ....................................................... 53

                          Appendix D. Audit Act 1994 section 16—submissions and comments...... 59

vi Accessibility of Mainstream Services for Aboriginal Victorians                     Victorian Auditor-General’s Report
Accessibility of Mainstream Services for Aboriginal Victorians
Auditor-General’s comments
                                   Victoria’s Aboriginal population is small relative to other parts of Australia. The 2011
                                   census reports that there are around 47 000 Aboriginal people in Victoria—0.9 per cent
                                   of the total Victorian population—and 55 per cent of Aboriginal Victorians are under
                                   25 years of age, compared to 32 per cent of the non-Aboriginal population.

                                   Despite some improvements, Aboriginal Victorians are still facing significant
                                   disadvantage compared to the rest of the Victorian population, and they access many
                                   mainstream services at lower rates than the rest of the population. Gaps persist in
                                   many areas including early childhood development, health outcomes, income and
                                   employment. Addressing these gaps is vital to improve life outcomes for Aboriginal
                                   Victorians, and ensure they receive equitable access to services they are entitled to.

                                   This audit assessed the accessibility of mainstream services for Aboriginal Victorians,
John Doyle                         including whether departments can demonstrate how improved access has, and is
Auditor-General                    expected to, improve outcomes for Aboriginal Victorians. The audit focused on
                                   whole-of-government and departmental policies, programs and strategies, as well as
                                   outcomes, covering early childhood, health and human services.

                                   My audit found little improvement in outcomes and in some cases, the gap between
                                   Aboriginal Victorians and the rest of the population has worsened. However, access to
                                   hospital services, maternal and child health services, public housing services and
                                   kindergarten has improved.

 Audit team                        Many of the audit findings reflect similar issues identified in past VAGO reports and
                                   various departmental reviews relating to disadvantaged sections of the population.
 Andrew Evans                      These groups have differing needs and challenges in accessing mainstream services.
 Sector Director
                                   In order to ensure they receive the same opportunities as the rest of the population,
 Peter Rorke                       departments and agencies need to be well informed about the needs of disadvantaged
 Team Leader                       groups, including Aboriginal people, and target their services and programs
                                   accordingly.
 Sophie Fisher
 Analyst                           In common with other whole-of-government initiatives that focus on vulnerable
                                   Victorians, there is an absence of effective leadership and oversight in Aboriginal
 Pablo Armellino
                                   affairs which has affected mainstream service delivery over many years. The
 Graduate Analyst
                                   Secretaries’ Leadership Group on Aboriginal Affairs (SLG) is responsible for
 Chris Sheard                      overseeing implementation of the Victorian Aboriginal Affairs Framework 2013–18
 Engagement Quality                (VAAF), and this has not been effective. To ensure that services are accessible—and
 Control Reviewer                  to achieve its intended outcomes—VAAF needs to be implemented with strengthened
                                   oversight and improved collaboration between departments.

           Victorian Auditor-General’s Report                  Accessibility of Mainstream Services for Aboriginal Victorians   vii
Accessibility of Mainstream Services for Aboriginal Victorians
Auditor-General's comments

                        I have made key recommendations for the Department of Premier and Cabinet through
                        the SLG to provide more active leadership and direction to make sure that
                        departments comply with the requirements of VAAF. I am pleased DPC has accepted
                        these recommendations and the SLG has recently created a new Inter-Departmental
                        Aboriginal Inclusion Working Group. It is important this group, the Office of Aboriginal
                        Affairs Victoria (OAAV) and the SLG actively oversee progress in developing and
                        implementing plans and actions to improve Aboriginal inclusion.

                        The report also contains a set of recommendations that apply to all government
                        agencies that may be responsible for providing services for Aboriginal Victorians. I am
                        confident that adopting these recommendations will assist agencies to ‘close the gap’,
                        thus improving the health and wellbeing of Aboriginal Victorians.

                        I intend to revisit the issues that my office has identified in this report to ensure they
                        are being appropriately addressed.

                        Finally, I wish to acknowledge and thank the staff of OAAV and the departments of
                        Education and Early Childhood Development, Health and Human Services for their
                        assistance and cooperation during this audit.

                        John Doyle
                        Auditor-General
                        29 May 2014

viii Accessibility of Mainstream Services for Aboriginal Victorians                  Victorian Auditor-General’s Report
Audit summary
                                  The Australian Aboriginal population faces considerable disadvantage when compared
                                  to the non-Aboriginal population. For example, there are significant gaps in early
                                  childhood development, lower participation in maternal and child health services and
                                  kindergarten, poorer health status and shorter life expectancy, higher disability rates
                                  and comparatively lower literacy and numeracy outcomes. Despite some recent
                                  improvements, these gaps are still prevalent in Victoria.

                                  Victoria’s Aboriginal population is small relative to other parts of Australia. The 2011
                                  census reports that there are around 47 000 Aboriginal people in Victoria—0.9 per cent
                                  of the total Victorian population—and 55 per cent of Aboriginal Victorians are under
                                  25 years of age, compared to 32 per cent of the non-Aboriginal population.

                                  In November 2008, the Council of Australian Governments agreed to the National
                                  Indigenous Reform Agreement (NIRA), which commits all Australian governments to
                                  achieving specific closing the gap targets. To address its commitments under NIRA,
                                  the Victorian Government has developed the Victorian Aboriginal Affairs Framework
Victorian Aboriginal Health
     Service (Fitzroy)            2013–18 (VAAF), which builds on the previous Victorian Indigenous Affairs Framework
                                  2010–13, as the primary whole-of-government framework for Aboriginal people. VAAF
                                  outlines criteria designed to provide more effective access to services and improve
                                  outcomes for Aboriginal Victorians.

                                  This audit examined the access to mainstream services for Aboriginal Victorians
                                  provided or funded by government departments, and it assessed whether departments
                                  can demonstrate how improved access has contributed, and is expected to contribute
                                  to improved outcomes. The audit focused on whole-of-government and departmental
                                  policies, programs, strategies and outcomes, covering early childhood, health and
                                  human services and excluding child protection and youth justice.

                                  Conclusions
                                  Despite departments developing programs aimed at closing the gap between the
                                  Aboriginal population and the non-Aboriginal population, there has been little
                                  improvement in outcomes, and in some cases the gap has worsened. However, there
                                  is improved service access as a result of programs such as the Aboriginal Quitline and
                                  Aboriginal Health Promotion and Chronic Care programs, and in some areas such as
                                  maternal and child health.

                                  An absence of effective leadership and oversight has adversely affected the delivery of
                                  mainstream services for Aboriginal Victorians over many years. The Secretaries'
                                  Leadership Group on Aboriginal Affairs (SLG) is responsible for overseeing the
                                  implementation of VAAF. This arrangement does not appear to have been effective,
                                  and there is limited evidence that the SLG is fulfilling its intended role. Crucially, it
                                  appears unable to ensure that VAAF is applied as intended across government.

          Victorian Auditor-General’s Report                  Accessibility of Mainstream Services for Aboriginal Victorians   ix
Audit summary

                        Similarly, the Office of Aboriginal Affairs Victoria (OAAV) does not oversee
                        departmental activities. OAAV advised it does not have the authority to direct the way
                        departments undertake their work and sees its role as one of coordination and
                        facilitation. There is a lack of accountability for delivery of actions because it is up to
                        individual departments to develop and implement their own plans, with limited
                        oversight. However, a new Interdepartmental Aboriginal Inclusion Working Group is
                        being created to provide for regular departmental engagement and oversight of plans
                        and associated processes.

                        OAAV was not able to quantify the total amount spent by the Victorian Government in
                        relation to services for Aboriginal people, and some departments had difficulty
                        providing complete financial information. Therefore, the total amount of funding is not
                        clear, and the lack of complete information makes effective monitoring of expenditure
                        problematic.

                        Departments have developed a range of plans, strategies and programs aimed at
                        improving access to services for Aboriginal people. Most of these have been in place
                        for five to 10 years and in the case of the Department of Health (DH), some for over
                        20 years. Since the introduction of VAAF in 2012, departments have not reviewed or
                        updated their plans to reflect the framework's focus on addressing service access. All
                        departments are required to complete their Aboriginal inclusion action plans by the end
                        of August 2014. Originally, they were due to be developed by the end of 2013, and
                        significant work remains for these plans to identify and address barriers to access to
                        comply with VAAF criteria. The plans should also include clear target measures and
                        milestones, and detail the requirements for monitoring, evaluating and reporting on
                        access and outcomes.

                        There is significant scope for departments to improve their monitoring, evaluation and
                        reporting of outcomes of Aboriginal service delivery strategies and programs. Except
                        for DH, there is little evidence that departments undertake robust evaluations to assess
                        the achievement of outcomes for Aboriginal Victorians.

                        Across all departments, weaknesses in the completeness and reliability of data mean
                        that it is difficult for them to accurately measure the achievement of outcomes. This
                        diminishes their ability to effectively monitor, evaluate and report progress on service
                        delivery plans. While there are challenges in obtaining data on the Aboriginal
                        population, more should be done to improve the completeness and reliability of
                        information, including data on population levels. Without improvements to the
                        completeness of data, departments cannot be assured that all Aboriginal Victorians
                        who are eligible for particular services are able to access them.

                        A lack of effective collaboration and coordination in planning and service delivery
                        between the departments and service providers, as well as at service delivery level
                        between local providers, creates difficulties for Aboriginal people, who have to navigate
                        multiple service providers to access services. SLG is tasked with coordination and
                        collaboration between departments, but there is limited evidence this is occurring.

x Accessibility of Mainstream Services for Aboriginal Victorians                    Victorian Auditor-General’s Report
Audit summary

                  Findings
                  Oversight and leadership
                  A lack of effective oversight and leadership has adversely affected the delivery of
                  mainstream services for Aboriginal Victorians. Given the deficiencies identified in this
                  audit—such as with Aboriginal action plans and strategies, data collection and sharing,
                  and program evaluations—there is a pressing need for SLG and OAAV to provide
                  more active leadership, direction and oversight to ensure that departmental programs
                  and strategies identify and address the needs of Aboriginal Victorians to facilitate
                  increased access and improved outcomes.

                  Consultation and engagement
                  There are a number of ways in which government departments consult and engage
                  with Aboriginal organisations and people. However, there is a lack of broad
                  consultation, and this limits community representation and is time consuming for
                  stakeholders who are on multiple committees.

                  Consistent with VAAF and Council of Australian Governments (COAG) principles,
                  broad consultation includes engaging Aboriginal community members and
                  organisations, as well as mainstream service providers, at all stages of program
                  development, implementation and evaluation to ensure diverse representation.

                  Many organisations—including Aboriginal community controlled organisations—that
                  provide feedback and advice to departments are directly funded by those departments,
                  which may diminish their capacity to provide constructive feedback. There is scope for
                  greater use of community consultation, which would strengthen overall consultation
                  processes.

                  Complete and reliable data
                  There are challenges for the audited departments in obtaining complete and reliable
                  data to identify needs, develop plans, evaluate programs and report outcomes—
                  particularly data relating to population levels. Despite these challenges, DH has had
                  data improvement processes in place for a number of years through strategies to
                  improve identification in public hospitals. The Department of Human Services (DHS)
                  more recently has moved to enhance data collection procedures to improve
                  completeness and reliability of datasets particularly relating to service accessibility for
                  Aboriginal Victorians, while the Department of Education and Early Childhood
                  (DEECD) is improving data collection in its maternal and child health service.

                  There is a clear imperative for departments to improve their data collection methods
                  and information sharing practices. Data sharing across departments is limited. Without
                  complete and reliable data, departments cannot be assured they are meeting the
                  service needs of Aboriginal people.

Victorian Auditor-General’s Report             Accessibility of Mainstream Services for Aboriginal Victorians   xi
Audit summary

                        Plans, programs and strategies
                        All departmental secretaries have agreed to finalise Aboriginal inclusion action plans
                        by the end of August 2014, but significant work remains for these plans to identify and
                        address barriers to access.

                        Overall, the quality of the audited sample of plans and strategies for the delivery of
                        services to Aboriginal Victorians in the audited departments was poor. They did not
                        meet many of the better practice criteria established in government policy framework
                        documents. Consequently, there is considerable scope for departments to improve
                        their plans and strategies under VAAF.

                        Collaboration and coordination
                        There is a lack of effective collaboration and coordination in planning and service
                        delivery between the departments and service providers, as well as at service delivery
                        level between local providers, despite this being a role of SLG. The successful
                        implementation of VAAF requires improved cross-government coordination. Feedback
                        from Aboriginal stakeholders, community organisations, service providers, and
                        departmental officers indicated that many problems with government services are the
                        result of a ‘siloed’ approach to service delivery that can impede access to services and
                        negatively impact outcomes. This creates difficulties as users have to navigate multiple
                        service providers to access services.

                        According to its terms of reference, SLG is responsible for strengthening coordination
                        and collaboration between departments. However, there is limited evidence this is
                        occurring and there is considerable scope for improvement in this area.

                        Access to services
                        Both DH and DEECD measure access to programs, and can demonstrate
                        improvements in accessibility in some services. At DH this is the case in a range of
                        areas, while at DEECD, gaps in participation in maternal and child health and
                        kindergarten have narrowed. However, this data needs to be viewed with caution,
                        because longer-term trends need to be considered rather than short-term increases or
                        decreases in participation and attendance. DHS can demonstrate increased access to
                        public housing—although overcrowding in public housing has increased—and to
                        homelessness services.

                        Evaluating outcomes
                        Despite the development of programs aimed at increasing access to close the gap
                        between Aboriginal and non-Aboriginal Victorians, there has been little improvement in
                        outcomes, and in some cases the gap has worsened.

xii Accessibility of Mainstream Services for Aboriginal Victorians                Victorian Auditor-General’s Report
Audit summary

                  Without effective evaluations, departments cannot be assured they have achieved or
                  are achieving targets under VAAF. Only DH demonstrated a rigorous program of
                  evaluation that assessed the achievement of outcomes for Aboriginal Victorians, and
                  this has been in place for a number of years.

                  While DEECD and DHS undertake some evaluations, neither could demonstrate a
                  comprehensive evaluation regime for Aboriginal programs, and it is difficult to
                  understand how these departments can assure themselves that plans, programs and
                  strategies are achieving positive outcomes for Aboriginal people.

                  Monitoring and reporting
                  The Victorian Government Aboriginal Affairs Report is submitted annually to the
                  Victorian Parliament. OAAV collects information from departments to publish in the
                  report. However, this report provides only a high-level analysis of outcomes against
                  targets in key areas and some basic data on trends. The information is not always
                  reliable because it depends on data provided by departments, which is of varying
                  quality. Departments also report to COAG, on their progress towards outcomes for
                  closing the gap between Aboriginal and non-Aboriginal Victorians.

                  Although departments report on results of their various programs, there is significant
                  scope to improve public reporting on the accessibility and outcomes of mainstream
                  services for Aboriginal Victorians.

                  Funding of services
                  Quantifying the Victorian Government’s expenditure on mainstream services for
                  Aboriginal Victorians is difficult. DEECD was not able to provide specific details on
                  expenditure for Aboriginal Victorians in maternal and child health, and DHS was unable
                  to provide specific funding details in relation to access of its mainstream services by
                  Aboriginal Victorians.

                  Although OAAV is the central policy group for Aboriginal affairs, it was unable to
                  provide any information on the amount of funding provided for programs related to
                  services for Aboriginal people across Victorian Government departments.

Victorian Auditor-General’s Report           Accessibility of Mainstream Services for Aboriginal Victorians   xiii
Audit summary

                        Recommendations
                             Number      Recommendation                                                          Page
                          That departments:
                                    1.   improve data collection and recording processes, including                 20
                                         collaborating with other departments, Aboriginal community
                                         controlled organisations and other relevant organisations to
                                         estimate Aboriginal populations for each service
                                    2.   as a priority, finalise Aboriginal inclusion action plans and              31
                                         fully apply Victorian Aboriginal Affairs Framework service
                                         access criteria in service delivery plans and programs
                                    3.   engage a broad range of Aboriginal people in developing,                   31
                                         implementing, monitoring and evaluating plans and
                                         programs
                                    4.   identify and pursue opportunities to collaborate, cooperate                31
                                         and share data with government agencies responsible for
                                         mainstream service delivery and with service providers
                                    5.   routinely evaluate plans and programs to determine whether                 46
                                         access is increasing and outcomes are improving, and to
                                         identify where improvements are needed
                                    6.   develop internal and external reporting regimes that provide               46
                                         comprehensive and informative data on the progress and
                                         outcomes of departmental plans and programs.
                          That the Department of Premier and Cabinet:
                                    7.   provides more active leadership and direction so that                      46
                                         departmental programs and strategies comply with the
                                         Victorian Aboriginal Affairs Framework 2013–18, and identify
                                         and address increased access and improved outcomes
                                    8.   through the Secretaries' Leadership Group on Aboriginal                    46
                                         Affairs, monitors the implementation of departmental plans,
                                         evaluates outcomes and monitors the development of
                                         investment logic maps that identify the funding requirements
                                         over the term of the government's commitment to the
                                         Victorian Aboriginal Affairs Framework 2013–18.

                        Submissions and comments received
                        In addition to progressive engagement during the course of the audit, in accordance
                        with section 16(3) of the Audit Act 1994, a copy of this report was provided to the
                        Office of Aboriginal Affairs Victoria and the departments of Education and Early
                        Childhood Development, Health, and Human Services with a request for submissions
                        or comments.

                        Agency views have been considered in reaching our audit conclusions and are
                        represented to the extent relevant and warranted in preparing this report. Their full
                        section 16(3) submissions and comments are included in Appendix D.

xiv Accessibility of Mainstream Services for Aboriginal Victorians                      Victorian Auditor-General’s Report
11.1
                        Background

                       Introduction
           1.1.1 Victoria's Aboriginal population
                       Victoria’s Aboriginal population is relatively small compared to other parts of Australia.
                       The 2011 census reports that there are around 47 000 Aboriginal people in Victoria—
                       0.9 per cent of the total population—an increase of around 40 per cent between 2006
                       and 2011. This growth is attributed to higher birth rates, migration to Victoria and
                       higher rates of people identifying as Aboriginal.

                       The Aboriginal population is relatively young, with 55 per cent of Aboriginal Victorians
                       under 25 years of age, compared to 32 per cent of the non-Aboriginal population.
                       Victoria’s Aboriginal population is distributed between metropolitan Melbourne—
                       46 per cent—and regional locations—54 per cent.

           1.1.2 Gap between the Aboriginal and non-Aboriginal
                 population
                       Australia-wide
                       The Australian Aboriginal population faces considerable disadvantage when compared
                       to the non-Aboriginal population—with gaps in early childhood health and
                       development, higher than average perinatal mortality rates, lower birth weights, and
                       lower participation in maternal and child health services and kindergarten. Aboriginal
                       people report higher levels of psychological distress and have a poorer health status,
                       shorter life expectancy and higher hospitalisation and disability rates. In education,
                       comparatively lower literacy and numeracy outcomes, and higher disengagement
                       rates, contribute to lower rates of Year 12 completion and tertiary education access.

                       The Victorian experience
                       Despite some improvements, Aboriginal Victorians are still facing significant
                       disadvantage compared to the rest of the Victorian population. There is a gap in health
                       and educational outcomes and therefore life outcomes between Aboriginal and
                       non-Aboriginal Victorians. The Council of Australian Governments (COAG) and the
                       Victorian Government have recognised the importance of addressing Aboriginal
                       disadvantage and closing the gap in outcomes.

Victorian Auditor-General’s Report                Accessibility of Mainstream Services for Aboriginal Victorians    1
Background

                      Data from the 2011 census indicates that the median age of Aboriginal Victorians is
                      22 years, 15 years younger than the median age of non-Aboriginal Victorians. The data
                      shows higher birth rates and a much shorter life expectancy for Aboriginal people
                      Australia-wide. The Australian Bureau of Statistics is not able to calculate specific
                      Victorian life expectancy rates at present because of the small size of the Victorian
                      Aboriginal population. A large gap in median weekly income is also reported—$390 for
                      Aboriginal and $562 for non-Aboriginal Victorians.

         1.1.3 Policy framework
                      National Indigenous Reform Agreement (Closing the Gap)
                      In December 2007, COAG created a partnership between all levels of government to
                      address Aboriginal disadvantage and close the gap between the Aboriginal and
                      non-Aboriginal population. In November 2008, COAG agreed to the National
                      Indigenous Reform Agreement (NIRA), which commits all Australian governments to
                      achieving the six Closing the Gap targets:
                      x    close the life-expectancy gap within a generation
                      x    halve the gap in mortality rates for Indigenous children under five within a decade
                      x    ensure access to early childhood education for all Indigenous four-year-olds in
                           remote communities within five years
                      x    halve the gap in reading, writing and numeracy achievements for children within a
                           decade
                      x    halve the gap in Indigenous Year 12 achievement by 2020
                      x    halve the gap in employment outcomes within a decade.

                      NIRA sets out an integrated strategy, which defines responsibilities, promotes
                      accountability, clarifies funding arrangements, and links to other initiatives contributing
                      to closing the gap. The agreement also identifies strategic areas for policies and sets
                      out policy principles, objectives and performance indicators.

                      Victorian Government Aboriginal Inclusion Framework
                      The Victorian Government Aboriginal Inclusion Framework was released in November
                      2011. It outlines a number of important actions that should shape Aboriginal affairs
                      policy. One of the key actions is to develop departmental action plans to demonstrate
                      how access to and inclusion in mainstream services will be improved. The framework
                      'is designed to be flexible in its implementation and departments and agencies will be
                      encouraged to develop their own plans, structures and strategies that suit the context
                      within which they operate'. It is intended to provide a tool to assist departments to
                      develop their action plans.

                      The framework outlines the main barriers Aboriginal Victorians face in accessing
                      services and resources. The main barriers are actual and perceived discrimination by
                      service providers, language and cultural barriers, lack of trust in services and
                      organisations, and lack of awareness of and engagement with local Aboriginal
                      communities.

2     Accessibility of Mainstream Services for Aboriginal Victorians              Victorian Auditor-General’s Report
Background

                       Victorian Indigenous Affairs Framework
                       First released in 2006, the Victorian Indigenous Affairs Framework (VIAF) focused on
                       Aboriginal childhood and early development, home environments, economic
                       sustainability, justice, and cultural identity. All government departments were required
                       to prepare Aboriginal Strategic Action Plans addressing key action areas and focusing
                       on interdepartmental collaboration.

                       VIAF operated between 2006 and 2012. It was revised in 2010 to produce VIAF
                       2010-13, which established Victorian-specific objectives and targets consistent with the
                       nationally agreed Closing the Gap targets for 2013, 2018 and 2023. The 2013 targets
                       were not reported against.

                       Victorian Aboriginal Affairs Framework 2013–18
                       In November 2012, the government released the Victorian Aboriginal Affairs
                       Framework 2013–18 (VAAF) which builds on the previous VIAF as the primary
                       whole-of-government framework related to Aboriginal affairs. It identifies six strategic
                       action areas, covering early childhood, education, economic participation, health and
                       wellbeing, safe families and justice outcomes, and strong culture and confident
                       communities. Each strategic area includes sub-objectives with specific improvement
                       targets and expected outcomes.

                       Many of the indicators under VIAF related to service access and participation and are
                       similar to the VAAF indicators and targets—for example, in action areas such as
                       improving maternal and early childhood health, and developing and improving
                       education outcomes.

                       VAAF requires all Victorian Government departments to have an Aboriginal inclusion
                       action plan consistent with the Victorian Government Aboriginal Inclusion Framework.

Victorian Auditor-General’s Report                Accessibility of Mainstream Services for Aboriginal Victorians    3
Background

         1.1.4 Access to services for Aboriginal people
                      Many services that Aboriginal people need are delivered by mainstream service
                      providers, including hospitals, maternal and child health services, schools and
                      kindergartens, and community and public housing. The general population is entitled to
                      access these mainstream services.

                      In addition, Aboriginal community controlled organisations (ACCO) provide a range of
                      services for Aboriginal Victorians, including mainstream services such as maternal and
                      child health, and more targeted services such as the Aboriginal Health Promotion and
                      Chronic Care program (AHPACC), funded by the Department of Health. In many
                      cases, these services exist to facilitate improved access to mainstream services. VAAF
                      outlines that a significant number of Aboriginal people—40 per cent nationally—rely on
                      ACCO-delivered services in areas such as health, child and family services, housing
                      and justice.

                      VAAF emphasises increasing take-up of services as the first step towards improved
                      outcomes for Aboriginal Victorians. It states that ‘the challenge for service providers is
                      to encourage or ensure that those targeted by a service actually use it’. In this context,
                      VAAF outlines seven criteria designed to provide better access to services for
                      Aboriginal Victorians and improve outcomes consistent with VAAF priorities. The seven
                      access criteria are listed in Figure 1A.

                                                           Figure 1A
                                         Key access criteria for effective service design
                      Criteria               Outcome
                      Cultural safety        Service provider understands client needs, including cultural needs
                      Affordability          Clients can afford to use required services
                      Convenience            Clients can get to the service easily
                      Awareness              Current and potential clients are informed about the availability of the
                                             service and its value
                      Empowerment            Current and potential clients know which services they are entitled to
                                             seek
                      Availability           Services that a client needs are accessible
                      Respect                Service provider treats the client with respect
                      Note: Cultural safety refers to an environment in which people feel safe, that they are respected
                      for who they are and what they need, and that their cultural identity is unchallenged.
                      Source: Victorian Auditor-General’s Office from the Victorian Aboriginal Affairs Framework
                      2013–18

                      VAAF recognises that more than any other state or territory, Aboriginal people in
                      Victoria have been directly affected by the Stolen Generation. The Stolen Generation
                      still has a significant impact on the way Aboriginal people feel about mainstream
                      services and the level of trust they have in services that were once used as
                      government instruments for removing Aboriginal children from their families. Also,
                      evidence indicates that historically, Aboriginal Victorians have been excluded or
                      discriminated against when trying to access mainstream services.

4     Accessibility of Mainstream Services for Aboriginal Victorians                  Victorian Auditor-General’s Report
Background

                       To achieve the highest level of service effectiveness, people first need to use the
                       service, which is not an automatic decision. People consider a range of factors in
                       making this choice. The most important challenge for all service providers, when
                       developing a program of services designed to achieve an outcome, is making sure the
                       intended users actually access the services.

                       In Victoria, mainstream services play a key role in providing health, education and
                       welfare services to Aboriginal people, as the Aboriginal population is quite small and
                       widely dispersed throughout the state.

                       According to a 2009 report by the Department of Education and Early Childhood
                       Development (DEECD), nearly a quarter of young Aboriginal people and adults had
                       problems accessing services. Long waits, cost and the service not being available
                       when required were the major reported barriers to accessing services. Lack of
                       adequate transport and distance were also commonly reported barriers.

                       At the 2010 Young Koori Parents Forum, organised by the Victorian Indigenous Youth
                       Advisory Council, young Aboriginal people, particularly young parents, reported limited
                       knowledge of services available to them, which negatively impacts the accessibility of
                       services.

           1.1.5 Identified barriers to access
                       Following our review of documentation—including plans, strategies and evaluation
                       reports—and discussions with audited departments, Aboriginal stakeholders and
                       service providers, we identified the main barriers to accessing mainstream services
                       experienced by Aboriginal people. These include a lack of culturally safe services and
                       a lack of awareness of the services available, racism, shame and fear, complex
                       administrative processes and affordability. Appendix A provides further details on
                       barriers to access and required actions.

           1.1.6 Roles and responsibilities
                       Figure 1B sets out the roles and responsibilities for the development and
                       implementation of Aboriginal affairs policy.

Victorian Auditor-General’s Report               Accessibility of Mainstream Services for Aboriginal Victorians    5
Background

                                                          Figure 1B
                                      Roles and responsibilities – Aboriginal affairs policy

                      Note: Working groups under the Overarching Indigenous Bilateral Plan Committee include the
                      Vulnerable Children's Working Group, the Economic Development Working Group, and the Data
                      Reform Working Group.
                      Source: Victorian Auditor-General's Office, based on information provided by the Office of
                      Aboriginal Affairs Victoria.

6     Accessibility of Mainstream Services for Aboriginal Victorians             Victorian Auditor-General’s Report
Background

                       Office of Aboriginal Affairs Victoria
                       The Office of Aboriginal Affairs Victoria (OAAV) was established within the former
                       Department of Planning and Community Development in December 2012 to combine
                       Aboriginal Affairs Victoria with the Aboriginal Affairs Taskforce. In July 2013 OAAV was
                       transferred to the Department of Premier and Cabinet. Consistent with its business
                       plan, OAAV takes a coordinated end-to-end approach to deliver the Victorian
                       Government's agenda for Aboriginal policy reform, community strengthening and
                       engagement, and cultural heritage management and protection. OAAV works with
                       Victorian Aboriginal communities and other partners to lead the whole-of-government
                       Aboriginal affairs reform agenda to improve the lives of Aboriginal Victorians. It is also
                       responsible for the effective implementation of the Aboriginal Heritage Act 2006 and
                       the Aboriginal Lands Act 1970.

                       Secretaries’ Leadership Group on Aboriginal Affairs
                       The Secretary of the Department of Premier and Cabinet chairs the Secretaries’
                       Leadership Group on Aboriginal Affairs (SLG), which has a membership comprising the
                       secretaries of all departments. SLG has a range of responsibilities, including
                       overseeing the implementation of VAAF and driving the development and
                       implementation of departmental Aboriginal inclusion action plans to ensure services
                       are accessible and inclusive for Aboriginal Victorians.

                       Senior Officers Group
                       The Executive Director of OAAV chairs a Senior Officers' Group on Aboriginal Affairs
                       with representatives from across Victorian Government departments. Its role is to
                       provide a forum for interdepartmental collaboration and coordination.

                       Government departments
                       Departments develop policies specific to their area and coordinate service provision for
                       Aboriginal Victorians. Each department should have an Aboriginal inclusion action plan
                       that guides it in developing policies and services that are culturally appropriate for
                       Aboriginal people. In terms of departmental responsibilities:
                       x     The Department of Health has three main focus areas, health, mental health and
                             aged care. The department works primarily in a funding and policy capacity,
                             funding a variety of mainstream and targeted services.
                       x     DEECD funds kindergarten programs, the Victorian Maternal and Child Health
                             Service, parenting services, and school and higher education.
                       x     The Department of Human Services either directly delivers or funds community
                             organisations to deliver child protection, out-of-home care and family services,
                             youth justice services, disability services, housing and homelessness services,
                             and concessions.

Victorian Auditor-General’s Report                Accessibility of Mainstream Services for Aboriginal Victorians    7
Background

                      Aboriginal Community Controlled Organisations
                      ACCOs are not-for-profit organisations that provide services to Aboriginal people and
                      are administered by the community they serve. They often run programs funded by
                      government departments involving partnerships with mainstream service providers.
                      Generally, their focus is on facilitating access to, and improving cultural safety of,
                      services for Aboriginal people. Their establishment and management is community
                      driven and largely regulated through state and Commonwealth legislation. Aboriginal
                      community controlled health organisations are well established types of ACCOs.

         1.2          Previous VAGO audits
                      Coordinating Services and Initiatives for Aboriginal People,
                      June 2008
                      The audit examined how well services and initiatives for Aboriginal people are planned
                      and coordinated across the Victorian public sector and specifically focused on the
                      governance and accountability arrangements in place to facilitate and monitor the
                      progress of VIAF.

                      The audit examined interdepartmental and intradepartmental arrangements, and found
                      that lack of coordinated program design was a key area for attention. Overall, the
                      findings indicated that the respective roles and responsibilities of the agencies involved
                      were unclear and cross-departmental collaboration was not evident. At a department
                      level, the audit found that the departments’ action plans were incomplete, or not clear
                      in terms of interdepartmental collaboration.

                      The audit also identified a lack of joint datasets for departments to monitor goal
                      achievement, and the need for a performance monitoring framework to monitor
                      progress.

                      Indigenous Education Strategies for Government Schools,
                      June 2011
                      The audit examined the implementation and delivery of the Wannik education strategy.
                      It found that the strategy had a solid planning base but the rigour was not sustained
                      throughout the rollout of the program, resulting in poor implementation. It also found
                      that there were no comprehensive plans covering implementation milestones and time
                      lines, stakeholder engagement and communications, and risk management. There was
                      insufficient information available and no reporting mechanisms that provided a picture
                      of the overall status of the Wannik strategy.

                      The audit reported that DEECD was unable to demonstrate that it was effectively
                      managing the range of risks to the strategy’s success. Rather than project-managing
                      the strategy, DEECD used a business-as-usual model with a limited accountability
                      system.

8     Accessibility of Mainstream Services for Aboriginal Victorians             Victorian Auditor-General’s Report
Background

                       Access to Education for Rural Students, April 2014
                       This audit assessed the effectiveness of DEECD's activities to ensure that Victorians in
                       rural areas have access to a high-quality education and that outcomes for these
                       students are maximised.

                       The audit concluded that DEECD has not provided access to high-quality education for
                       all students, and while DEECD undertakes many activities that assist rural educators
                       and students, these have not resulted in significantly improved performance. The
                       report, however, did acknowledge that DEECD's Smarter Schools National
                       Partnerships program for people in low socio-economic areas had improved oral
                       language skills among Indigenous students and the capacity of teachers to work with
                       disadvantaged students.

           1.3         Audit objective and scope
                       The audit objective was to assess the accessibility of mainstream services for
                       Aboriginal Victorians.

                       The following criteria address the audit objective:
                       x    departments have a sound understanding of the service needs of Aboriginal
                            people
                       x    departments develop and implement effective plans, programs and strategies to
                            facilitate access to services for Aboriginal Victorians and address identified needs
                       x    departments can demonstrate how improved service access has contributed, and
                            is expected to contribute, to improved outcomes for Aboriginal Victorians
                       x    there are effective monitoring, reporting and evaluation frameworks in place,
                            underpinned by reliable data on service access, to demonstrate the achievement
                            of intended outcomes.

                       This audit examined access to mainstream services for Aboriginal Victorians, including
                       targeted programs and strategies designed to support access to these services, which
                       are mainly services provided or funded by departments.

                       The audit focused on whole-of-government and departmental policies, programs and
                       strategies, as well as outcomes, covering early childhood, health and human services.

                       The following departments were part of the audit:
                       x    Department of Premier and Cabinet—Office of Aboriginal Affairs Victoria
                       x    DEECD
                       x    Department of Health
                       x    Department of Human Services.

                       The audit examined specific services within early childhood, health, and human
                       services—excluding child protection and youth justice. Appendix B sets out the
                       mainstream services and key related strategies and programs provided by
                       departments in this audit.

Victorian Auditor-General’s Report               Accessibility of Mainstream Services for Aboriginal Victorians    9
Background

         1.4          Audit method and cost
                      The audit was conducted in accordance with section 15 of the Audit Act 1994 and
                      Australian Auditing and Assurance Standards. Audit evidence was gathered through:
                      x    meetings with each of the four audited departments, including regional staff
                      x    meetings with service providers and other stakeholders, including in regional
                           areas
                      x    review of government frameworks and policy for Aboriginal affairs
                      x    review of departmental plans, programs and strategies, including examination of
                           evaluations, reviews and progress reports.

                      Pursuant to section 20(3) of the Audit Act 1994, unless otherwise indicated, any
                      persons named in this report are not the subject of adverse comment or opinion.

                      The cost of this audit was $335 000.

         1.5          Structure of the report
                      The report is structured as follows:
                      x    Part 2 discusses whether departments have a sound understanding of the needs
                           of Aboriginal Victorians
                      x    Part 3 discusses departmental plans, programs and strategies
                      x    Part 4 discusses access, outcomes and governance.

10      Accessibility of Mainstream Services for Aboriginal Victorians        Victorian Auditor-General’s Report
2             Understanding the needs of
                        Aboriginal Victorians
                       At a glance
                       Background
                       Victorian Government departments need a sound understanding of the service needs
                       of Aboriginal Victorians to be able to design and deliver services which are accessible.

                       Conclusion
                       Audited agencies have a reasonable understanding of the service needs of Aboriginal
                       Victorians. However, this is constrained by a lack of broad consultation and complete
                       and reliable data.

                       Findings
                       x     Audited departments have established both structured and informal processes for
                             consulting and engaging with stakeholders and representatives of Aboriginal
                             organisations. However, existing processes are limited in breadth.
                       x     There are challenges for the audited departments in obtaining complete and
                             reliable data to identify needs, to develop plans, and to evaluate programs and
                             report outcomes, particularly data relating to population levels.
                       x     While there is evidence of data sharing across departments, this is limited and—
                             without improving data collection methods and information-sharing practices—
                             departments cannot be assured they are meeting the needs of Aboriginal people.

                       Recommendation
                       That departments improve data collection and recording processes, including
                       collaborating with other departments, Aboriginal community controlled organisations
                       and other relevant organisations to estimate Aboriginal populations for each service.

Victorian Auditor-General’s Report              Accessibility of Mainstream Services for Aboriginal Victorians   11
Understanding the needs of Aboriginal Victorians

           2.1         Introduction
                       Departments need a sound understanding of the service needs of Aboriginal Victorians
                       if they are to design and deliver services that are accessible and achieve improved
                       outcomes. This Part assesses whether departments have a sound understanding of
                       the needs of Aboriginal Victorians that can inform the development of robust plans for
                       service delivery.

           2.2         Conclusion
                       Audited departments have a reasonable understanding of the service needs of
                       Aboriginal Victorians. However, this is constrained by a lack of broad consultation and
                       of complete and reliable data. Although there are challenges for the departments in
                       obtaining data to identify needs—including data on population levels—data collection
                       could be improved.

                       The Department of Health (DH) has an extensive program of evaluation that assists it
                       to understand Aboriginal service needs, but neither the Department of Education and
                       Early Childhood Development (DEECD) nor the Department of Human Services (DHS)
                       were able to demonstrate similarly comprehensive evaluation programs to assist them
                       in understanding the needs of Aboriginal Victorians. DHS and DEECD provided limited
                       evidence of extensive consultation. DH provided evidence of extensive consultation at
                       a state and local level with both mainstream and Aboriginal organisations. However,
                       existing processes are limited in breadth. With respect to consultation:
                       x     Some regional stakeholders indicated that a lack of broad consultation limits
                             community representation and is time-consuming for stakeholders on multiple
                             committees.
                       x     Many organisations, including Aboriginal community controlled organisations
                             (ACCO) that provide feedback and advice to departments are directly funded by
                             those departments, which may diminish their capacity to provide open and
                             constructive feedback. Greater use of community consultation, including with
                             service users, would strengthen the consultation process and provide
                             departments with views unencumbered by funding relationships.

12       Accessibility of Mainstream Services for Aboriginal Victorians          Victorian Auditor-General’s Report
Understanding the needs of Aboriginal Victorians

           2.3         Understanding Aboriginal service needs
           2.3.1 Consultation and engagement
                       Under the Victorian Aboriginal Affairs Framework (VAAF), consultation and
                       engagement with Aboriginal people is fundamental to the achievement of government
                       objectives for Closing the Gap, and can only be achieved through 'genuine
                       engagement' with both the community and Aboriginal organisations and peak bodies.
                       Under the National Indigenous Reform Agreement (NIRA) to close the gap, Victoria
                       committed to specific service delivery principles for programs and services for
                       Indigenous Australians, including the Indigenous engagement principle:
                            'Engagement with Indigenous men, women and children, and communities
                            should be central to the design and delivery of programs and services.'

                       Both VAAF and NIRA make clear the importance of engaging community members as
                       well as ACCOs and mainstream service providers in all aspects of service delivery.

                       Consultation and engagement is therefore vital to ensure that services are accessible,
                       ensure that planned actions take into account the views and experience of Aboriginal
                       people and the community, and evaluate service effectiveness. There are a number of
                       ways in which government departments consult and engage with Aboriginal
                       organisations and people. These are discussed in this section.

Victorian Auditor-General’s Report             Accessibility of Mainstream Services for Aboriginal Victorians    13
Understanding the needs of Aboriginal Victorians

                       Department of Education and Early Childhood Development
                       The main consultation process DEECD uses to inform its approach to Aboriginal
                       inclusion involves quarterly meetings with the peak Aboriginal education body in
                       Victoria—the Victorian Aboriginal Education Association Incorporated (VAEAI). DEECD
                       provides funding to VAEAI, which has a committee of management that is made up of
                       the leaders of 32 Local Aboriginal Education Consultative Groups located across the
                       state. Records of meetings are not comprehensive but indicate that these meetings are
                       not used solely for consultation but also to update VAEAI members on DEECD
                       initiatives.

                       DEECD has a service agreement with the Victorian Aboriginal Community Services
                       Association Limited, with which it has quarterly meetings. DEECD also provided
                       evidence of consultation with the Victorian Aboriginal Child Care Agency and the
                       Victorian Aboriginal Community Controlled Health Organisation.

                       Evidence provided by DEECD relating to these relationships does not indicate that
                       consultation is robust, nor is it clear if DEECD uses this consultation to assist it in
                       understanding the needs of Aboriginal people. Also, there is insufficient evidence of
                       rigorous engagement with the local community.

                       However, DEECD does have a reasonable understanding of the needs of Aboriginal
                       people. It has been aware of problems with access to services for some time,
                       evidenced by issues raised in past reports including the State of Victoria’s Children
                       2012: Early Childhood Report which discusses gaps in development between
                       Aboriginal children and the rest of the population.

                       A departmental review of the maternal and child health (MCH) service in 2013 raised a
                       number of issues with this service, including a lack of strategies to increase the
                       participation of Aboriginal children and families. DEECD has known of issues with the
                       delivery of this service since a 2006 review undertaken when MCH was part of DHS.
                       The recommendations of these reviews are quite similar. For example, both reviews
                       recommended:
                       x     use of outcome, rather than input, measures to monitor and evaluate system
                             performance
                       x     improvements to workforce management models and development of strategies
                             to support the future service delivery model
                       x     implementing a formal professional development program that supports the
                             workforce strategy.

                       The review findings indicate there has been little change over time in ensuring the
                       MCH service is able to support vulnerable cohorts such as Aboriginal families on a
                       statewide basis. This highlights prolonged inaction by the department in addressing
                       needs and developing and finalising plans and strategies.

14       Accessibility of Mainstream Services for Aboriginal Victorians           Victorian Auditor-General’s Report
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